Download Services, repairs and warranty

Hearing Loss answer line – Responses to your
questions on the new hearing loss regulations
The following are our responses to your questions on the Accident Compensation
(Apportioning Entitlements for Hearing Loss) Regulations 2010, grouped by
subject category. The original question numbers have been retained for your
reference.
Services, repairs and warranty
21. Can receiver wires be replaced under the $200 off site repairs
provision? This is a major hearing aid component and must be ordered
in, however usually - but not always - the repair can be effected in the
clinic.
If this service is performed off site then the client can choose to use ACC’s
contribution of up to $200 (ex GST) towards off site repairs. However, if this
service is performed on site then it would be as per the on site service
contribution i.e. up to a maximum $50 (ex. GST) per service, maximum two
service per year.
22. Is the $200 (ex. GST) per client or per device? If the client has
two, then they are discriminated against if it is $200 per client.
The entitlement for an off-site repair of hearing devices is maximum $200 (ex
GST) per client and is paid once every two years after the manufacturer’s
warranty for the devices has expired. The sum available from ACC is intended
as a contribution to the costs of a client’s hearing devices.
23. What happens if the aid needs repair during warranty period, but
it is not a manufacturing defect – e.g. wax has got into the
instrument, or water damage? Presumably it is the client’s cost.
ACC will contribute to the cost of repairs after the manufacturer’s warranty for
the device has expired. Any off-site costs incurred during the warranty period
lie with the client.
36. There is provision for 2 onsite repairs per year.
hearing aid or per visit?
Is that per
It is per visit.
37. The $200 for offsite repairs per two years - is that $200 per
hearing aid or just a total of $200 in repairs for 2 years?
The contribution of a maximum of $200 is payable for one visit every two
years after the warranty has expired. The visit may involve repair of more
than one device belonging to the same client.
45. Regarding on and off site repairs (where there are two repairs on
site per year), is this two per aid or two per client? Also, regarding
one off site repair every two years, is this per aid or per client?
For on-site repairs, ACC will contribute to two services per client each year.
For off-site repairs, ACC will contribute to one repair per client every two
years ($200 ex GST) (also see Question 22 and 37).
52. In the Detailed Implementation Pack regarding examples of
where to use onsite repair and maintenance it states “Client presents
to clinic stating that hearing aids are lacking clarity. Fault finding
determines issues with wax impairing the function of aids. After a
clean out the hearing aids are working satisfactorily. Client has
presented once in the past year so the cost of the repair can be
invoiced to ACC up to a maximum of $50.00 (ex. GST).” Could you
please confirm that an onsite repair fault finding does not need to be
performed by an MNZAS Audiologist?
ACC does not specify that onsite repairs need to be carried out by MNZAS
audiologists. This is no change to the pre 1 January 2011 process.
59. Could you clarify whether the $50 onsite (HL20) and $200 off-site
(HL21) charges have to be used as a single charge, or if they can be
made up of multiple transactions.

HL20: e.g. a client’s earmould is retubed at a cost of $15.00 – is there $35.00
remaining for them to use, or have they used up one of their services for the
year and they lose the $35.00?

HL21: e.g. a client’s hearing aid is sent away and has a minor repair charge of
$60.00 – is there $140.00 remaining for them to use, or have they used up
their two-year repair and lose that $140.00?
The client is entitled to a maximum of two on site services per year and the
maximum cost the corporation can contribute to each service is $50. The
client is entitled to a maximum of one off site repair every two years from the
end of the warranty period. The maximum cost the corporation can contribute
to this repair is $200. Multiple transactions can be made during a
repair/service, but any balance cannot be carried over to subsequent repairs.
If the actual cost is lower than the maximum entitlement ACC would expect to
be charged the lesser amount.
60. If during the warranty period a repair is required that is not
covered by the warranty, will the client be entitled to $200 subsidy?
No. ACC’s contribution to repairs is prescribed by the new regulations, which
state that “the cost to which the claimant is entitled is payable for a maximum
of 1 repair every 2 years from the end of the warranty period on the device”
(Regulation 10(3)). This means that ACC cannot contribute to off-site repairs
during the warranty period, regardless of whether the particular off-site repair
is within the scope of the warranty coverage, and thus any costs incurred lie
with the client. (Also see Question 23.)
73. Is the ACC contribution for a repair based entirely on the
manufacturers invoice or can we include a modest fee to cover
handling time and courier charges? Nowhere is this specifically
clarified that I could find. Otherwise a claimant will always have to be
charged a co-payment even if ACC’s contribution is not fully used. Offsite repairs always incurs costs for a clinic and can’t be treated in
isolation.
ACC's contribution is toward the cost of repairing the device. If you consider
that this cost includes handling time and courier charges, you can include
these costs in your invoice and ACC will pay up to $200 (ex GST) once every
two years.
76. I would like to get clarification on invoicing repairs under the new
regulations for two examples we have encountered (assuming of
course that the client has not already used either entitlement).
A). Onsite repairs – can two HL20’s be charged for a service on the
same day? An example might be a client who attended an
appointment for a full retune, refit of hearing aids and was also
supplied some consumables to maintain proper function of their
hearing aids.
B). Offsite repairs – is it acceptable to invoice for an HL20 if an onsite
repair is unsuccessful and a subsequent offsite repair is needed? (i.e
the invoice would have both an HL20 and an HL21)
For question A, in such circumstances, the client may choose to use both on
site service contributions up to a maximum of $50 (excl. GST) each. However,
the client should be made aware that they will not be eligible for another on
site service contribution for at least 12 months.
For question B, as the client has not already had their regulated limit for
services and repairs, then invoicing for both on site service and off site repair
would be acceptable.
80. If an offsite repair from the manufacturer costs $150 (inc GST)
and our courier handling fee costs ($20 inc GST) will ACC pay $170 inc
GST or will the patient have to pay the $20. In this instance the
manufacturers invoice will of course say $150 but our invoice to ACC
will be more?
ACC's contribution is toward the cost of repairing the device. If you consider
that this cost includes handling time and courier charges you can include
these costs, as well as a description of the services over and above the
manufacturers costs, in your invoice and ACC will pay up to $200 (ex GST)
once every two years. In the example you have provided, ACC would pay both
the $150 and the $20 (inc GST) under the service code HL21.
81. If a claimant attends an appointment for a hearing test (that is
paid for by ACC) and uses one of their on-site repairs for fine tuning
($50 +GST) do we need to provide ACC with a report to let ACC know
what happened at the appointment?
The ACC612 Audiometric Report is used to advise ACC the outcome of an
audiometric test. A report regarding the outcome of any on site (or off site)
repair is not required, we just need your invoice to describe the service/repair
that was performed eg fault finding.
82. I have a question regarding Earmoulds for our ACC clients. Are we
able to invoice these under HL21 offsite repairs? Earmoulds are $130
per pair and the allowance is $200 every two years. The Earmould
gets made offsite. An ear impression also would be required which is
$45. The fitting of the Earmoulds is another $45. All this totals
$220.00. This falls under the amount able to be used for the offsite
repair. Is this allowed?
ACC classifies Earmoulds as accessories for hearing aids therefore are part of
the contribution to the devices. As such, the only provision for ACC
contribution towards Earmoulds is at the time of the fitting and not for the
manufacturing or Earmould impression appointments.
When fitting replacement Earmoulds, the audiologist's time involved could be
charged as an on-site service if the client elects to use the service allocation
that way. ACC will contribute up to $50 (excl. GST) towards a maximum of
two on site repairs in any 12 month period. The manufacture of the
replacement Earmould (which is performed off-site) can be charged as an offsite repair if the client elects to use the repair allocation that way. ACC will
contribute up to $200 (excl. GST) once every two years outside the warranty
period of the device(s).
83. Can you please clarify the 12 month period in which two on-site
repairs are due to a client? Is it 12 months from the fitting, 12 months
from the finalisation or is it the calendar year since the new regs took
effect (Jan to Jan?). That question would also pertain to the off-site
repair every two years.
For both on-site services and off-site repairs we will always look backwards
from the service date in question to see if the entitlements have been used
within the applicable periods. That is one year for on-site services and two
years for off site repairs once the device(s) is outside of the warranty period.
As the regulations came into force on 1 January 2011, we will be looking back
to that date in the first instance. So calendar year is irrelevant.
86. Given that hearing aids purchased under the old contract will not
be considered for replacement unless the old criteria for replacement
are met (eg cannot be repaired), surely the old criteria for servicing of
those hearing aids still stands i.e. no limit to repairs. It seems grossly
unfair that the hearing aids are being viewed as "under the contract"
for replacement but servicing of those same hearing aids must be
under the new regulations. Please clarify your justification or take
this discrepancy into consideration. It seems that the claimant is
disadvantaged on both counts.
The ‘old criteria’ you refer to are the legislative criteria for determining
whether ACC is liable to meet the costs of maintaining, repairing or replacing
a hearing aid or device, and still apply (see Clause 13, Schedule 1 of the
Accident Compensation Act 2001). What the regulations do is set out how
much ACC is liable to contribute, and in what circumstances, if the legislative
criteria are met.
ACC will allow eligible clients in this situation to choose whether to have their
existing hearing aids repaired (as per regulated rates) or receive ACC's
contribution toward new aids. If they choose to receive the contribution, they
should be aware that a contribution to new aids will not be available again for
another 6 years, as per regulated limits.
Audiometric assessment/testing and hearing needs
assessment/reassessment
13. Are we still required to do a needs assessment or needs
reassessment before ordering new aids?
Under the new regulations, ACC will no longer require a formal hearing needs
assessment/reassessment report to be submitted. ACC expects that
audiologists will determine the appropriate hearing device(s) for the client to
trial before placing an order, as for non-ACC clients. ACC considers as part of
good clinical practice the audiologist will complete an assessment of the
individual client’s needs and this is part of the overall fitting fee service, to
which we will contribute as per the new regulations.
27. Are ENTs going to be allowed to test air conduction as they have
been doing up to now in non-proof testing conditions? Typically no BC
or speech or tymps are performed.
From 1 January 2011, ACC will provide ENTs with an audiometric assessment
that has been completed by an audiologist. ACC will only request a second
audiometric assessment if it considers the first one to be inaccurate.
38. Will the yearly hearing aid review this still be funded by ACC or
will clients need to fund it themselves? If it is to be funded by ACC has
the invoicing code changed?
ACC will only contribute to audiometric testing costs once every 6 years.
Clients will need to pay for any hearing review costs they incur more
frequently than this.
43. Does ACC expect that an audiologist will perform a hearing needs
assessment? Is ACC contributing to the cost of the hearing needs
assessment under the regulations? If so, how much is ACC
contributing? Where in the regulations is payment for hearing needs
assessments provided for?
ACC would expect that an assessment of the client’s needs will occur as part
of good clinical practice in determining the appropriate hearing aids to fit for a
client regardless of whether the aids were funded by ACC. ACC no longer
requires the paperwork or the specific ACC assessment that was used to
support the hearing needs assessment under contracted arrangements and
therefore a separate fee will no longer be paid.
58. Our client has two Resound Canta ITEs received in 2004. He has
been struggling greatly with them and is not wearing them. I have
loaned him some of our loan BTE aids which he is wearing in the
meantime and finds them much better. With the new contract coming
into effect on 1 Jan, and we no longer have to do a Needs
Reassessment, how do I now get our client reassessed for new
hearing aids?
If the client chooses to seek replacement hearing aids on or before 31
December 2010 a hearing needs assessment is required. If the replacement
hearing aids are sought on or after 1 January 2011 a new audiometric
assessment is required under regulations to be submitted to ACC. Once ACC
receives this we will issue a funding decision to the client which will detail
their entitlements. Once the client has received a contribution to hearing aids
under the regulations, he will not be able to get new ones for another six
years.
62. Can you please inform me of the process required now (as of 1
Jan) to get replacement aids? Now that Needs Reassessments are no
longer required, do I just get the patient in for a hearing assessment
and write a letter to ACC requesting replacement aids? Is there
another form that ACC may have for this? Who pays for this
assessment?
For details of process for applying for replacement hearing aids, see page 11
of the Audiologists’ detailed information pack, available under Question 18.
ACC will pay for an audiometric assessment once every 6 years under the
Regulations.
63. Please could you send through an electronic version of the new
NAL tables?
The new NAL tables are viewable here on the New Zealand Legislation
website, as part of the Accident Insurance (Occupational Hearing Assessment
Procedures) Amendment Regulations 2010.
67. My client had a hearing test performed in 2009 and at that stage
the hearing aids were functioning well. He came in recently and the
hearing aids were sent to the manufacturer and they were deemed
obsolete and not repairable (no spare parts available due to the age of
the aids). Now he needs new hearing aids, but he will need a more
recent hearing test. Will ACC pay for another hearing test (as the
Hearing Loss Audiometric Report requires a current audiogram)?
Yes, ACC will pay for a new audiometric assessment as long as the client has
not had one funded already since the regulations came into force on 1 January
2011. This audiometric assessment must be provided to ACC. On receipt of
the audiometric assessment ACC will issue a funding decision to the client on
what funding can be provided towards replacement hearing aids. Once this
audiometric assessment has been completed and paid for by ACC, ACC will
not be able to contribute to another audiometric assessment for six years.
68. If a client needs a hearing test (because their last one was more
than six years ago) and they are happy with their current hearing
aids, do we fill in the Hearing Loss Audiometric Report? Or do we send
our own typed report?
The intention of the audiometric assessment is to determine whether a client
has a need for hearing aids, and to apply for a contribution from ACC (and
Ministry of Health where there is also non-injury hearing loss). ACC must
receive this information on the standard report form (ACC612). Bearing in
mind that ACC can only contribute toward this cost once every six years from
the first time the client has this assessment under regulations, if the client is
happy with their current hearing aids now, but there is a chance they may
need new aids over the next six years, the client may choose not to seek ACC
funding for this assessment in order to save it for a later date. In this case,
ACC would not require any paperwork.
72. When does the 6-year period begin in terms of billing ACC for an
HL01 - is it as of Jan 1 2011? Or is it dated from the last time ACC was
billed for a "Hearing Review" under the old contract, or even perhaps
the last time ACC was billed for an "Audiogram Report" as per the old
contract?
The 6 year period begins from the date that the first Audiometric Assessment
is undertaken under Regulations. After that, ACC is unable to fund
Audiometric testing for a further 6 years. If you are unsure, please contact
your ACC Hearing Loss Team to confirm if funding is available prior to
completing the testing.
78. Which version of the ACC612 Hearing loss audiometric report
should audiologists use from 1 January 2011 onwards?
There is only one valid version from 1 January 2011. This can be located
through the publications section of the ACC website at
http://www.acc.co.nz/publications/index.htm.
79. Please clarify the current situation regards compliance with the
new ISO standard. It seems there are different interpretations of the
maximum permissible sound levels for test conditions and I'd like to
know exactly which one to base our room measurements on so that
we can ensure compliance. If we need to order sound proof booths
we'll need plenty of time to do this.
We refer you to the Audiologists Detailed Implementation Pack (DOC 1.1M).
In particular page 9 of the embedded document, the Summary of Guideline
for diagnosis of occupational noise-induced hearing loss. Part 3: Audiometric
standards.
All test environments used for diagnostic audiology should meet the ambient
noise requirements for bone conduction testing. As a result, test
environments should comply with the ambient noise levels specified in the
right hand column (titled “Bone conduction audiometry”) in table 1 in the
summary document.
81. If a claimant attends an appointment for a hearing test (that is
paid for by ACC) and uses one of their on-site repairs for fine tuning
($50 +GST) do we need to provide ACC with a report to let ACC know
what happened at the appointment?
The ACC612 Audiometric Report is used to advise ACC the outcome of an
audiometric test. A report regarding the outcome of any on site (or off site)
repair is not required, we just need your invoice to describe the service/repair
that was performed eg fault finding.
88. If a patient (first fitted under old regulations) needs replacement
hearing aids now, even if they are over 6 years old, I understand we
submit an ACC 612 form. What other documentation does one need to
attach?
Audiologists should provide ACC with a completed ACC612 and attach a
summary of their audiometric findings for the client. Note that the six year
re-aiding limit applies from the first time the client receives hearing aids under
the regulations (ie it does not have to have been six years since existing
clients received their last set of aids for them to re-apply for aids under the
new regulations).
92. Clients that are being treated for trauma injuries require a hearing
assessment at the beginning of the treatment to assess the level of
hearing loss and one at the end of the treatment to determine the
outcome of the treatment. Occasionally, there may be one or more
further hearing assessments required at the various stages
throughout the treatment (as identified by the clients ENT). The
regulations state that ACC will only contribute to an audiometric
assessment at least once every six years, but this appears to
disadvantage clients with trauma injuries. Please advise how we deal
with hearing assessments for trauma clients.
Clients that are being provided treatment under a trauma claim can have
hearing assessments as required by their ENT. Audiologists that have clients
referred to them for such assessments must obtain prior approval from ACC
which can be obtained by email or a phone call to the Hearing Loss Unit that
services the audiologist’s area. We have implemented two new services codes
for trauma claims:
HL02 Hearing Loss - Trauma
Assessment Pre-treatment
HL03 Hearing Loss - Trauma
Assessment Post-treatment

Cost is $107 (excl. GST)

To be used for the first assessment
of trauma induced hearing loss, and

Where there is a need to have one
or more ongoing assessment as part
of the course of treatment

Cost is $155 (excl. GST)

To be used as the final assessment
to determine the outcome of the
treatment

Must be submitted with an ACC612
report (as per HL01).
Should a
hearing loss claim eventuate as a
result of the trauma injury, this
report may be used as the
assessment for the hearing loss
claim.
Regulations
3. Will the regulations address the issue of Manufacturers providing
incentives to Audiology Providers to encourage prescription of their
products?
No. Regulations set out the client’s entitlement to hearing services support.
18. Will the regulations address the issue of Manufacturers providing
incentives to Audiology Providers to encourage prescription of their
products?
No. Regulations set out the client’s entitlement to hearing services support.
4. Will ACC continue to fund remote controls and other accessories for
hearing aids, as are currently funded?
ACC will fund hearing devices according to the definition set out in the
regulations (excerpt below):
devices means –

(a) hearing aids:

(b) accessories for hearing aids, including, but not limited to, remote
controls:

(c) consumables, excluding batteries, for the items in paragraphs (a) and
(b).
39. Do the new regulations apply to hearing loss due to brain injury
and medical misadventure? How will these claimants be managed?
Yes, the new regulations apply to all hearing loss claims. Contribution for
hearing loss from traumatic or treatment injury will be determined in the
same way as claims for occupational noise-induced hearing loss, although
they tend to be managed more closely (eg by case managers). Depending on
the severity of the injury, different rehabilitation may be appropriate for these
clients.
47. Can you let me know if the standard from 1 January 2011 for
audiometric assessment means an objective calibration every 3
months of the audiometer, or every 2 years as it is currently the
practice? Is ACC going to contribute with the payment of this
calibration? If needed only for ACC clients to be every 3 months when
are the bills expected to be paid to the audiology clinics? And if there
are delays can we charge ACC an interest for late payment of let’s say
15%?
Compliance with AS ISO 8253.1-2009 comes into force on 1 January 2012, a
year after the other changes, to allow audiology clinics to make any necessary
modifications. ACC will not contribute to the costs of calibration.
AS ISO 8253.1-2009 recommends that periodic objective tests are carried out
every three months. However, this is a guideline only, and section 12.2 of the
standard acknowledges that a different interval should be used if there is
evidence it would be more appropriate. ACC considers such evidence to be
provided by the report by Suzanne Purdy and Warwick Williams (Guideline for
diagnosis of occupational noise-induced hearing loss). A summary of their
report (available on page 9 of the Audiologists’ detailed information pack
referred to under Question 18) sets out the following requirements:
“Formal calibration of all audiometric test equipment shall be carried out on an
annual basis for equipment that moves between testing locations or biennially
for equipment kept in a fixed testing location. Calibration will be undertaken
by an accredited testing laboratory with full documented traceability to
National Standards. Formal calibration shall be carried out in accordance with
the relevant ISO and IEC standards (IEC 60318, IEC 60645 & ISO 389). Daily
listening checks are very important. A brief listening check should be carried
out on a daily basis.”
49. Will the new regulations apply to clients whose hearing loss
claims are managed by other insurance providers (e.g. CRM and
AON)?
Yes, accredited employers and third-party administrators such as CRM and
AON are required to abide by the same legislation and regulations as ACC.
This means that they must pay as a minimum the ACC regulation entitlements
for entitled clients.
63. Please could you send through an electronic version of the new
NAL tables?
The new NAL tables are viewable here on the New Zealand Legislation
website, as part of the Accident Insurance (Occupational Hearing Assessment
Procedures) Amendment Regulations 2010.
65. I have a client who was declined hearing aids as his hearing loss
was 6% attributed to Noise Induced Hearing loss and 17% to other
causes – can they reapply for hearing aids under the new scheme?
And if yes, when?
The introduction of the regulations does not change any previous entitlement
decisions issued by ACC.
70. Can we have some scenario examples of how the regulations
work?
NOTE: All of the following scenario examples are based on fitting of Binaural
Aids. Prices quoted are exclusive of GST.
SCENARIO 1
On 1 January 2011 Client A submits a claim to ACC for ONIHL. Client A is still
working and has a 20% total loss with 19% attributed to ONIHL see example
1a. The client proceeds with hearing aids and has them fitted.
Example 1a
Total Loss%
20%
ACC funded % of Total Loss
ONIHL%
19%
ACC Contribution Band
Traumatic Injury%
Hearing Aid ($)
Treatment Injury%
MOH Contribution ($)
Fitting Fee
95%
10: 90-100%
$3,000.00
$0.00
$1,200.00
Client A then approaches ACC on 2nd January 2017 requesting funding for
replacement hearing aids. Client A had continued to work from 1st January
2011 until retiring in 2015 and had been exposed to noise at work during that
time. Client A now has a total loss of 23% (determined by a new audiogram)
and ONIHL of 20% (determined by a new ENT assessment).See example 1b
Example 1b
Total Loss%
23%
ACC funded % of Total Loss
ONIHL%
20%
ACC Contribution Band
Traumatic Injury%
Hearing Aid ($)
Treatment Injury%
MOH Contribution ($)
Fitting Fee
87%
9: 80-89.9%
$2,700.00
$88.00
$1,080.00
Client A then approaches ACC on 3rd January 2023 requesting funding for
replacement hearing aids, is now retired, and has had no further exposure to
occupational noise since retiring in 2015. Client A now has a total hearing
loss of 32% (determined by a new audiogram) with ONIHL still at 20%. A
new ENT assessment is not considered necessary given that the client has not
been exposed to further workplace noise. See example 1c
Example 1c
Total Loss%
32%
ACC funded % of Total Loss
ONIHL%
20%
ACC Contribution Band
63%
7: 60-69.9%
Traumatic Injury%
Hearing Aid ($)
$2,100.00
Treatment Injury%
MOH Contribution ($)
$266.00
Fitting Fee
$840.00
SCENARIO 2
Client B has approached ACC for a new claim for noise induced hearing loss.
Client B has a total hearing loss of 7% and all of this is attributed to ONIHL.
The client is retired and no longer working. See example 2a. The client
proceeds with hearing aids and has them fitted.
Example 2a
Total Loss%
7%
ACC funded % of Total Loss
ONIHL%
7%
ACC Contribution Band
10: 100%
Traumatic Injury%
Hearing Aid ($)
$3,000.00
Treatment Injury%
MOH Contribution ($)
Fitting Fee
100%
$0.00
$1,200.00
10 years later the client requests funding for replacement aids. The new
audiogram shows that the client now has a total hearing loss of 25%. There
is no reason to re-visit the earlier ENT assessment as the client has not been
exposed to further workplace noise in the last 10 years, meaning that the
previous decision to attribute 7% to ONIHL remains. See example 2b.
Example 2b
Total Loss%
ONIHL%
25%
7%
ACC funded % of Total Loss
ACC Contribution Band
28%
3: 20-29.9%
Traumatic Injury%
Hearing Aid ($)
$900.00
Treatment Injury%
MOH Contribution ($)
$622.00
Fitting Fee
$360.00
SCENARIO 3
Client C was fully funded for hearing aids prior to regulations being
introduced. Client C had a total loss of 25% with an ONIHL of 12%. Client C
requests funding for replacement hearing aids and his total loss is now 26%
with ONIHL of 13%. This was determined by a new ENT assessment because
Client C had been working and has been exposed to workplace noise since the
previous ENT assessment see example 3a.
Example 3a
Total Loss%
26%
ACC funded % of Total Loss
ONIHL%
13%
ACC Contribution Band
50%
6: 50-59.9%
Traumatic Injury%
Hearing Aid ($)
Treatment Injury%
MOH Contribution ($)
$356.00
Fitting Fee
$720.00
SCENARIO 4
$1,800.00
Client E approaches ACC for a new hearing loss claim. It is determined that
the client has a total loss of 30% with a traumatic hearing loss from a loud
explosion of 10% as determined by an ENT assessment. See example 4a.
Example 4a
Total Loss%
30%
ONIHL%
Traumatic Injury%
Treatment Injury%
ACC funded % of Total Loss
ACC Contribution Band
10%
Hearing Aid ($)
33%
4: 30-39.9%
$1,200.00
MOH Contribution ($)
$532.00
Fitting Fee
$480.00
89. In a hypothetical example whereby a patient had aids fitted in
2007 (4 yrs old) but then got equipment such as a telephone or
doorbell system in 2009 (2 yrs ago), then is their 6 year funding
period dated from the hearing aid fitting or the extra equipment – i.e.
can they get funding again for aids in 2013 or 2015?
The six year re-aiding limit applies from the first time the client receives
hearing aids under the regulations. In your example, the dates the client last
received ACC-funded equipment are irrelevant – it’s a “blank slate” from 1
January 2011. See also Questions 67, 68 and 72.
90. For a new patient under new regulations, what would be the
scenario if aids were fitted in 2011 and they then received extra
equipment (such as a telephone) in 2013? When would they be
eligible for further funding (2017 or 2019)?
ACC’s contribution is only available when devices are first fitted. Any funding
not spent at the first fitting cannot be carried over to subsequent fittings. In
your example, and assuming eligibility criteria are met, ACC would contribute
to hearing aids in 2011, and contribute again six years later in 2017. The
client would be responsible for any new aid or device costs (such as a
telephone) in the interim.
93. My understanding was that before regulations it was an “all or
nothing” contribution for hearing aids from ACC. Now the regulations
are stating that there is part payment for those with accepted hearing
loss. My client’s hearing loss was accepted but the total cost of the
cover for hearing aids was declined [pre-regulations]. Shouldn’t these
people now be able to have their case reviewed and have hearing
costs paid for depending on what accepted hearing loss they have i.e.
what band they fall into?
As you note, prior to the introduction of regulations, ACC funded the full cost
of hearing aids where the need for the hearing aid was a direct consequence
of the covered injury (as per our legislation). The introduction of the
regulations has not changed the legislative requirement that the need for the
hearing aid/s must be as a result of the covered injury. What has changed is
that regulations now prescribe how much ACC can contribute (matched to the
level of injury-related loss as a proportion of the client's total hearing loss),
once a need arising from the covered injury has been established.
Without having all the details of the case you describe it is difficult to
comment, as each case is assessed on its own merits. However, in general
terms, if the client’s need for the entitlement was not as a result of their
covered injury prior to regulations, and the client’s injury-related needs have
not changed since ACC's previous decision, then it is unlikely that the previous
decision would change. The client would not be entitled to funding under the
regulations as the need for the rehabilitation would still not be as a result of
the covered injury.
Prices/costs and contracts
1. Will there still be an ACC price list for hearing Aids? If so, what
format will this be in?
No, ACC does not intend to continue with the ‘ACC pricelist’.
2. Do you intend to maintain contracts with Hearing Aid
Manufacturers?
No. ACC does not intend to continue to maintain contracts with Hearing Aid
Manufacturers.
8. What is the Audiology Provider allowed to charge for ACC
apportioned hearing aids? Can they charge only wholesale price, or
are they allowed to charge a margin on the hearing aids?
Regulations set out the entitlements that ACC can provide clients. The
audiologist will determine what they charge for hearing aids. In some
instances, there will be co-payments and such arrangements will be between
the client and the audiologist.
11. What happens to the current 5% prompt payment discount from
the Suppliers?
Regulations set out the client’s entitlement to hearing services support. Under
the new arrangements, audiology practices will be able to agree prices and
any discounts with their suppliers as they see fit.
41. If the hearing device(s) costs less than the client’s hearing device
contribution, how do we invoice this?
The Ministry of Health contribution is considered a top up and therefore the
cost of that service code is reduced accordingly. For example (using hearing
device service codes only and ex. GST):
ACC and MoH hearing devices contribution total = $2,156 ($1,800 from ACC,
$356 from Ministry of Health).
Actual cost of hearing devices = $1,980.
ACC approval letter
Value
HLBN06HD Hearing Loss – ACC Funding: two new hearing aids
$1,800
HLBN06MH Hearing Loss – MoH subsidy: two new hearing aids
$356
Audiologist invoice
Value
HLBN06HD Hearing Loss – ACC Funding: two new hearing aids
$1,800
HLBN06MH Hearing Loss – MoH subsidy: two new hearing aids
$180
57. The Vendor information pack states in the key changes that
“Clients will use a combination of government funding and their own
financial resources to purchase their hearing devices, in consultation
with their audiologist of choice”. Could you please confirm that the
ACC and MoH hearing aid/device funding, is for contribution towards
the actual cost of the device from an Audiologist, not the wholesale
cost?
Refer to Question 8.
75. If ACC is to pay $1035.00 towards the cost of Hearing Aids and
$414.00 towards the fitting fee can the MOH contribution of $715.00
be used towards either the Hearing Aids or the fitting, since the $414
will not cover the fitting costs.
The Ministry of Health contribution is a top up to the ACC hearing aids
contribution and therefore can only be used towards the cost of hearing aids.
77. There is some confusion on funding of Aids. Can I please seek
clarification? Example:
Say the Manufacturers Wholesale price for two Aids is $3,000 and the
audiologists Retail Price is $4,000. Say ACC has approved $3,500 for
both Aids (this is only for the aids).
A. Will ACC pay $3,500 and the Client needs to pay $500?
OR
B. Will ACC pay only $3,000 [Whole sale Price] although approval was
for $3,500 and the Client needs to pay $1,000?
The funding contribution from ACC (including the Ministry of Health in this
context) is a contribution towards the cost that would be payable by the
client. In other words, the wholesale cost is irrelevant in determining what
ACC will pay; ACC's approved contribution amount should be subtracted from
the client's total invoice for hearing devices, and the client is required to pay
any balance.
In the example provided, as ACC's funding is $3500, and the total cost to the
client was $4000, ACC would contribute $3500, and the client would be
required to pay the remaining $500. The wholesale cost is irrelevant.
84. After a client has been in for a hearing loss assessment report and
has received an acceptance from ACC stating their banding and the
amount of subsidy they are entitled too – is there a time frame for
them to use this subsidy in? i.e. the aids they choose or are best for
their life style will require a top up payment by the client – they
decide they will wait a year or so to do this – will the funding still be
available for them or does it have an expiry date?
There is no expiry date on ACC’s decision on entitlement funding, subject to
legislation and regulations staying the same. However, if the acceptance
decision was issued more than 12 months before fitting, the client should
contact ACC to ensure than no further assessment is required and to obtain a
valid purchase order number.
85. We invoiced ACC for aural toileting, using contract code AUD01,
which was declined by ACC. I understand that under regulations
general nurses can charge $15.72 (incl. GST) for ear treatments such
as cleaning (code NCON) – although in this case the aural toileting
was performed by an audiologist, not a general nurse. Can you
please explain why the code AUD01 was declined?
ACC will only pay for ear toileting when it is performed by a general nurse or a
specialist ear nurse (registered with ACC) and that service is submitted for
payment under the correct service code (RNP100 for specialist ear nurses or
NCON for general nurses). ACC will not pay for ear toileting services if
performed by anyone other than general nurses or specialist ear nurses. This
was the case before the regulations came in to effect as well.
Consumables, accessories and peripheral hearing
services
4. Will ACC continue to fund remote controls and other accessories for
hearing aids, as are currently funded?
ACC will fund hearing devices according to the definition set out in the
regulations (excerpt below):
devices means –

(a) hearing aids:

(b) accessories for hearing aids, including, but not limited to, remote
controls:

(c) consumables, excluding batteries, for the items in paragraphs (a) and
(b).
15. Will ACC cover the cost of consumables other than batteries such
as tubing, filters etc?
Consumables (such as tubing and filters) fall under the definition of hearing
devices in Regulation 4. As such, the client may (choose to) use some of
ACC's contribution to the cost of hearing devices for each ear to pay for these
consumables at the time of hearing aid fitting. ACC's contribution to hearing
devices is available no more than once every six years.
Batteries will continue to be provided by ACC direct to clients through the
current processes.
55. I understand that under the new system, we won’t be paid for HT
unless we have the ACC letter requesting one. However, we have
several booked in for an ENT visit in January. ACC have booked them
with us and the ENT on the same day, the earliest ENT appointments
available. The appointment requests come to us from the ENT, and
they then notify ACC who write to the client, advising of those
appointments. Can you please confirm how we should proceed with
these appointments to ensure we can be paid?
There is no change to the current hearing therapy process. It has always
been a requirement for providers to seek approval from ACC before
commencing this service.
40. Are accessories such as Dry and Store units still supplied on
request to prevent ongoing maintenance problems experienced by
some claimants?
Accessories for hearing aids such as Dry and Store units are considered
accessories under the hearing devices definition and can therefore be
purchased as part of the hearing devices contribution under regulations. Any
costs that exceed this contribution lie with the client.
12. As of 01/01/11 will hearing clinics be able to claim money for ACC
clients receiving ear nurse appointments?
ACC will continue to purchase ear nursing services where appropriate, such as
when ear ‘toileting’ is required as a result of in-the-ear hearing devices. ACC
purchases this service in two ways. First, under regulations, general nurses
can charge $15.72 (inc. GST) for ear treatments such as cleaning (code
NCON). Second, on a non-contracted basis, specialist ear nurses registered
with ACC can charge $46.00 (inc. GST) for ear toileting by microscope (code
RNP100). Ear nursing services are not covered by the new regulations.
20. Could you please confirm if consumables such as tubes and domes
and receiver wires can be billed under the $50 HL20 charge. Under
the new detailed information HL 20 pack it says they cannot, then on
page 4 it specifies "replacement of consumables".
Yes, the client can choose to use ACC’s contribution to the servicing of hearing
devices to have their consumable(s) replaced. However, if they do this they
may not be able to use ACC’s contribution to pay for something else (e.g.
repair of hearing aid), as regulated limits apply.
32. What happens when clients need their next lot of consumables,
are they paid for by ACC just as batteries are, or is that a cost to the
patient?
If the cost of consumables can't be included in the service or repair
contribution, the cost lies with the client. ACC will only supply batteries direct
to the client
46. Consumables – will these remain fully funded by ACC or will
clients contribute – also is there a limit on each consumable per aid
per year?
Refer to Question 32.
82. I have a question regarding Earmoulds for our ACC clients. Are we
able to invoice these under HL21 offsite repairs? Earmoulds are $130
per pair and the allowance is $200 every two years. The Earmould
gets made offsite. An ear impression also would be required which is
$45. The fitting of the Earmoulds is another $45. All this totals
$220.00. This falls under the amount able to be used for the offsite
repair. Is this allowed?
ACC classifies Earmoulds as accessories for hearing aids therefore are part of
the contribution to the devices. As such, the only provision for ACC
contribution towards Earmoulds is at the time of the fitting and not for the
manufacturing or Earmould impression appointments.
When fitting replacement Earmoulds, the audiologist's time involved could be
charged as an on-site service if the client elects to use the service allocation
that way. ACC will contribute up to $50 (excl. GST) towards a maximum of
two on site repairs in any 12 month period. The manufacture of the
replacement Earmould (which is performed off-site) can be charged as an offsite repair if the client elects to use the repair allocation that way. ACC will
contribute up to $200 (excl. GST) once every two years outside the warranty
period of the device(s).
85. We invoiced ACC for aural toileting, using contract code AUD01,
which was declined by ACC. I understand that under regulations
general nurses can charge $15.72 (incl. GST) for ear treatments such
as cleaning (code NCON) – although in this case the aural toileting
was performed by an audiologist, not a general nurse. Can you
please explain why the code AUD01 was declined?
ACC will only pay for ear toileting when it is performed by a general nurse or a
specialist ear nurse (registered with ACC) and that service is submitted for
payment under the correct service code (RNP100 for specialist ear nurses or
NCON for general nurses). ACC will not pay for ear toileting services if
performed by anyone other than general nurses or specialist ear nurses. This
was the case before the regulations came in to effect as well.
91. We have had people coming in who have evacuated from
Christchurch due to the earthquake and who were unable to get their
batteries prior to leaving their homes. Is ACC able to accept any
batteries being invoiced by clinics to tide these people over. The
batteries are normally very slow being dispatched from the distributor
and as at this stage the people do not know how long they will be out
of Christchurch, they need assistance now. We have been giving
packets away - but as this will go on for a while yet - have you put
anything into place?
We have discussed this situation with our supplier (Propharma) and amended
the battery order process for those clients impacted by the earthquake. If a
client asks an audiologist for batteries the audiologist should contact ACC and
advise the client's name, battery type, numbers of packs and the client's
temporary delivery address. ACC will immediately process the order and
Propharma will endeavour to despatch the batteries the same day. This
should result in delivery to the client within a maximum of two working days.
Hearing services documentation and client/provider
communications
6. Does ACC intend to provide an Information Pack specific for
Manufacturers?
No, but a copy of the vendor information pack has been emailed to the
manufacturers on the list held by ACC.
7. Will it be possible to see a draft of the brochure outlining all
Government funding prior to the proposed availability mid-December?
No. This is a cross-government document intended for people who have or
think they have hearing loss. ACC will provide copies of the document to the
hearing sector once published.
17. Can we have access to client funding communications?
A number of client factsheets have been created which will be published
shortly. In the meantime, the fact sheet Helping with your hearing loss (DOC
92KB) is available.
18. Detailed implementation pack
The Audiologists’ detailed information pack (DOC 1,134KB) provides detailed
information for implementing the regulations.
33. I cannot find the ACC5647 form on the website. Can you please
direct me to that?
The ACC5647 (Your guide to help with hearing loss) is available at
http://www.acc.co.nz/publications/index.htm. However, it is not a form, it is
a brochure outlining government support for people with hearing loss. Please
contact [email protected] if you would also like a hard copy.
34. Where is the ACC324 (Confirmation of Successful Trial)?
The ACC324 is an existing form and can be searched for at
http://www.acc.co.nz/publications/index.htm. This form is also included in
the Audiologists' detailed information pack located in question 18 of these
questions and answers. Please note that this form will be retired as at 1
January 2011 and replaced by ACC611 Hearing Aid trial outcome report.
35. Forms 612 (Hearing Loss Audiometry) and 611 (Trial Outcome) are they available yet?
Both of these forms are in the Audiologists' detailed information pack, which
was emailed to the audiology email list held by ACC on 7 December 2011.
This pack is also available through Question 18 of these Questions and
Answers.
53. Do you have any examples of the types of letters audiologists will
be receiving regarding entitlements and contributions?
Yes, we have an example of a Hearing aid approval letter (DOC 50K) .
69. What information about the regulations is being sent to existing
hearing loss clients?
Clients are being sent HLSIS07 Changes to funding for hearing services from
1 January 2011 (PDF 46K).
74. I understand that once a hearing loss claim is lodged with ACC the
client will receive a letter detailing how to go about getting an
audiometric assessment. Can you please provide an example copy of
the this letter (HLS14) or at least provide more detailed information
about what this letter advises (i.e. is the client given a list of MNZAS
audiologist who they can see for their audiometric assessment?).
Here is an example of a HLS14.letter (DOC 60K)
Transitional claims
19. Can we have examples of how the regulations will work during
transition?
Transitional Hearing Service Requests
Scenario

Purchase order for providing fitting
of hearing aids issued by ACC 29
December 2010

Client doesn’t visit audiologist to
have aids fitted until 15 January
2011.
Payment Method for Hearing Aids and
Fitting Fees
Contract rates apply – purchase approval
honoured for up to 12 months.

Needs assessment completed and
received by ACC on 29 December
2010

ACC doesn’t consider it/make
decision until 15 January 2011.

Client has received cover decision
and is waiting to have a hearing
needs assessment appointment with
an audiologist

Client can’t get an appointment with
an audiologist before 1 January
2011.
Contract rates apply – because the
needs assessment was received by ACC
before 1 January 2011.
a
Regulated rates apply – entitlement has
not been determined at this stage.
Transitional Repairs Requests
Scenario
Payment Method for Repairs

Client visits audiologist for off-site
repair on 15 December 2010

Audiologist
sends
manufacturer for repair

Manufacturer’s invoice for repair
and service is dated 27 December.

Client visits audiologist for off-site
repair on 29 December 2010

Audiologist
sends
manufacturer for repair

Manufacturer’s invoice for repair
and service is dated 15 January
2011.

Client visits audiologist for on-site
repair (service) on 15 December
2010

Repair completed on-site the same
day.

Client visits audiologist for on-site
repair (service) on 10 January 2010

Repair completed on-site the same
day.
aid
aid
Contracted rates apply – manufacturer’s
service date is before 1 January 2011.
to
to
Regulated rates apply – key date for offsite repairs is service date and this is
after 1 January 2011.
Contracted rates apply - service date is
before 1 January 2011.
Regulated rates apply - service date is
after 1 January 2011.
24. How will manufacturers know if it is a transitional claim? Can we
ask the audiologist to submit a copy of the ACC paper work when they
place their order?
Seeking advice from audiologists is one way that manufacturers can confirm
whether a claim is treated under the transitional provisions. Manufacturers
can also contact ACC for this information at the following addresses:

Hamilton Hearing Loss Unit - [email protected]

Dunedin Hearing Loss Unit - [email protected]
25. What sort of time frame do you anticipate for transitional claims?
Can we expect all orders to be processed by 31 January?
We will aim to make decisions as quickly as possible over the immediate
transitional period, but unfortunately are not able to specify a particular date
as this will depend on the information required to make a decision on
individual claims. If you have concerns about a particular claim, please
contact the relevant ACC Hearing Loss Unit on:

Hamilton Hearing Loss Unit - [email protected]

Dunedin Hearing Loss Unit - [email protected]
26. ACC has indicated that any claimant needs assessments received
prior to 31 December 2010 will be handled under the terms of the
current contract, even if the order for the instruments is posted after
1 January 2011. If a manufacturer is planning on introducing new
products early in the new year there is a good chance the audiologist
may feel the new product is the most appropriate to meet the
claimant’s needs. Of course any such product would not be on any
existing ACC price list, so how will it be funded? Will it be necessary
to submit pricing for distribution, or can some other arrangements be
made?
Unfortunately not. Because the contracted rates will be paid for these
transitional claims, the product must be on the existing contracted price list.
61. Phonak are about to release a new array of aids and would expect
that some clients who will still be provided aids under the 'old' system
will be prescribed these. They are currently not on the price list. How
will we deal with these?
Refer to Question 26. If a client chooses a hearing aid that is not on ACC’s
current manufacturers’ price list, only regulated contributions will be paid by
ACC.
66. I ordered replacement moulds for a client who had his aids funded
3 years ago – the moulds were ordered before Christmas but have
been invoiced by the manufacturer and received in January. Will ACC
cover the cost of these moulds for him or does this come into the
$200 off site repair code?
If the date of the invoice for the ear moulds is on or after 1 January 2011,
regulations apply, and ACC can only contribute up to $200 (ex GST). For
more examples, see information on transitional repairs requests under
Question 19.
Apportionment and banding
28. Can you give us an example of how the bands and percentages
will work? For example someone with NAL: 20% loss age deduction
5%. How will this work? This is a client with a typical NIHL shape
with normal hearing in the low frequencies.
All clients will receive a decision letter from ACC confirming their financial
contribution, which will help the client and audiologist understand the funding
assistance provided.
In the example you've used, let's assume the remainder after age deduction is
all attributed by the ENT to occupational noise-induced hearing loss (ONIHL),
i.e. the client has 20% total hearing loss, made up of 15% ONIHL and 5%
age-related hearing loss. Only the ONIHL is covered by ACC.
ACC would calculate how much of the client's total hearing loss is due to
injury in the following way:
15% / 20% = 75% covered injury-related hearing loss as a proportion of the
total hearing loss. The client would therefore fall into Band 8 (70.0%-79.9%).
For hearing devices, the client would be eligible for $1,200 (for each ear) from
ACC, as well as $89 (for each ear) from the Ministry of Health; the total
amount for hearing devices is administered by ACC. For fitting fees, the client
would get $960 from ACC. ACC would also contribute to assessment, service
and repair costs. Prices quoted are ex GST.
29. Is the total 100% considered from total loss % or from total
hearing as it is now?
'Total' means the total percentage hearing loss of a client, as determined by
the audiometric testing at the time of ACC’s decision.
31. If a person is in, for example, Band 6 which provides $1078 (ex.
GST) but their hearing aid wholesale cost is $750 (ex. GST), I
understand they can add in other devices and accessories such as a
remote control or ear moulds etc as long as the total cost comes in
under that figure. So, if the actual cost totals $950 do we claim the
$1078 (ex. GST) on their behalf, or only the $950 (ex. GST)?
As you note, the hearing devices contribution can be used for hearing aids as
well as accessories such as remotes or ear moulds. ACC‘s contribution states
the maximum amount we will contribute in the client’s Band, but it still relates
to the actual cost of good supplied. So if the price charged to the client is less
than the ACC and MOH entitlement then the audiologist can only claim
reimbursement for the price charged, so in the example given, the audiologist
would invoice ACC for $950 (ex. GST).
44. What guidance will the ACC provide to an ENT specialist to assist
them to exactly determine which band a claimant falls into?
ACC will determine what band a client falls into, based on the percentage level
of total hearing loss (provided by an audiologist) and the percentage level of
covered injury-related hearing loss (provided by an ENT specialist).
93. My understanding was that before regulations it was an “all or
nothing” contribution for hearing aids from ACC. Now the regulations
are stating that there is part payment for those with accepted hearing
loss. My client’s hearing loss was accepted but the total cost of the
cover for hearing aids was declined [pre-regulations]. Shouldn’t these
people now be able to have their case reviewed and have hearing
costs paid for depending on what accepted hearing loss they have i.e.
what band they fall into?
As you note, prior to the introduction of regulations, ACC funded the full cost
of hearing aids where the need for the hearing aid was a direct consequence
of the covered injury (as per our legislation). The introduction of the
regulations has not changed the legislative requirement that the need for the
hearing aid/s must be as a result of the covered injury. What has changed is
that regulations now prescribe how much ACC can contribute (matched to the
level of injury-related loss as a proportion of the client's total hearing loss),
once a need arising from the covered injury has been established.
Without having all the details of the case you describe it is difficult to
comment, as each case is assessed on its own merits. However, in general
terms, if the client’s need for the entitlement was not as a result of their
covered injury prior to regulations, and the client’s injury-related needs have
not changed since ACC's previous decision, then it is unlikely that the previous
decision would change. The client would not be entitled to funding under the
regulations as the need for the rehabilitation would still not be as a result of
the covered injury.
Claims process
48. Could you please explain the process to be followed when an ACC
claimant requires replacement of hearing aids that are more than six
years old and are not meeting the claimant’s needs or can no longer
be repaired? Will ACC require a report from an audiologist explaining
why the aids need replacement? Will ACC pay for the claimant’s
review appointment? Who will determine the funding band for the
replacement hearing aids? Will the claimant have to wait for an ENT
assessment to establish hearing loss percentages before funding can
be determined?
For details of the re-aiding process, refer to page 11 of the Audiologists’
detailed information pack (see Question 18). ACC no longer pays for hearing
reviews, but can contribute $155 (ex GST) to an audiometric assessment once
every six years to determine whether replacement hearing aids are needed
and the level of any financial contribution.
As is the case now, a new ENT assessment will only be sought if we have
reason to suspect there is an error with the original ENT decision or an
updated assessment is required, for instance because the client has been
exposed to workplace noise since the last ENT assessment. Otherwise, ACC
will use the information from the previous ENT assessment and the latest
audiogram to determine what contribution we can now make to replacement
hearing devices.
50. Can you give us an idea of the time frame likely from application
to fit approval for new applicants?
There are many factors that can affect the timeframes for ACC making a
decision on whether to approve entitlement funding. These include the
availability of specialist resources, time taken for clients and employers (if
required) to return questionnaires. If you are concerned about the
timeframes for a specific client please contact ACC. The hearing loss
Regulations are not expected to impact decision timeframes.
51. Are new applicants given a choice of provider by ACC for their
hearing assessment and again for their fitting or is it presumed they
will go back to the provider chosen in the first instance.
It will be up to the client to see the audiologist of their choice at all stages of
the claims process. For details of the claims process under regulations, please
refer to page 10 of the Audiologists’ detailed implementation pack (see
question 18).
54. When the claimant receives approval from ACC, will they be given
a list of local provider clinics?
ACC will stop sending the list of local provider clinics to clients with the
funding approval letter as in all cases the client will have already visited an
audiologist for a audiometric assessment and it is likely that most clients will
return to the audiologist who they have previously seen.
55. I understand that under the new system, we won’t be paid for HT
unless we have the ACC letter requesting one. However, we have
several booked in for an ENT visit in January. ACC have booked them
with us and the ENT on the same day, the earliest ENT appointments
available. The appointment requests come to us from the ENT, and
they then notify ACC who write to the client, advising of those
appointments. Can you please confirm how we should proceed with
these appointments to ensure we can be paid?
There is no change to the current hearing therapy process. It has always
been a requirement for providers to seek approval from ACC before
commencing this service.
62. Can you please inform me of the process required now (as of 1
Jan) to get replacement aids? Now that Needs Reassessments are no
longer required, do I just get the patient in for a hearing assessment
and write a letter to ACC requesting replacement aids? Is there
another form that ACC may have for this? Who pays for this
assessment?
For details of process for applying for replacement hearing aids, see page 11
of the Audiologists’ detailed information pack, available under Question 18.
ACC will pay for an audiometric assessment once every 6 years under the
Regulations.
71. How will ACC determine which vendor receives the referral to
carry out an HL01 on a new claimant?
Under the new system, ACC does not make a referral - it is up to the client to
choose an audiologist to complete the audiometric assessment and report
(HL01).
Miscellaneous
3. Will the regulations address the issue of Manufacturers providing
incentives to Audiology Providers to encourage prescription of their
products?
No. Regulations set out the client’s entitlement to hearing services support.
5. The regulations state a minimum trial period of 2 weeks, is there a
maximum trial period allowed?
No. The trial period is a clinical decision made by audiologists in consideration
of each individual client’s needs and circumstances. The maximum trial period
is a matter between audiologists and their suppliers.
9. Will the Audiology Providers be required to comply with the
Ministry of Health Section 88 notice on invoices for ACC apportioned
hearing aids?
The planned Ministry of Health Section 88 notice is expected to apply only
where hearing aids are funded solely by the Ministry of Health. As such, it
would not apply to audiology providers when the fitting of hearing aids is
funded by ACC alone or jointly by ACC and the Ministry. However, both
agencies expect audiology providers to provide a professional and appropriate
service for clients.
10. Can ACC provide copies of the standard AS ISO 8253.1-2009:
Audiometric test methods, Part 1: Basic pure tone air and bone
conduction threshold audiometry?
Unfortunately not because standards are subject to copyright. You can
organise to view ACC’s copy in Wellington, or order one yourself from
Standards New Zealand for approximately $100 (ex GST).
What we can provide is a summary of a report that will shortly be published
by Suzanne Purdy and Warwick Williams, titled Guideline for diagnosis of
occupational noise-induced hearing loss. Part 3: Audiometric standards. The
summary may be of use because it discusses the maximum permissible
ambient noise levels for the purpose of ACC assessments, which are taken
from the new ISO standard. This summary will be incorporated into the
detailed information pack that will be sent to audiologists before midDecember.
14. Are any appointments covered for a claimant after the trial is
over? eg. an annual review, problems, fitting moulds, etc.
ACC's contribution to the fitting fee is intended as a contribution to the fitting
of devices as well as follow-up services, and is payable no more than once
every 6 years. ACC will contribute to services and repairs of a client's hearing
devices as per the new regulations (ie maintenance up to $57.50 (inc. GST)
no more than twice per year, repairs up to $230 (inc. GST) once every 2 years
after the warranty period). It is up to the individual client to pay for services
required beyond those that ACC contributes to.
16. How is ACC going to keep track of individual entitlements?
ACC has systems and processes in place that identify all costs against all
claims.
30. Has ACC /MoH seen how much hearing aids costs overseas? My
impression is 3 times more in UK, around 4 times more in USA and 5
to 6 times more in South America. We have clients that come to NZ to
get hearing aids while on holiday. Maybe NZ is the cheapest country
from the OECD? This is worth investigating, as overheads in private
clinics are very high, and staff are well paid. Lowering our incomes is
going to impact on everyone, i.e. loss of jobs, reduced quality of
service, reduced time allocation per client, closure of some clinics and
putting more pressure on the public audiology clinics that are hardly
coping with the paediatrics.
Thank you for your comments. The Government has signalled that it
considers these changes will ensure there is a reasonable level of financial
support to help people access hearing services in New Zealand.
42. Can you clarify what happens in the case of an insurance claim for
instruments? Can the audiologist go ahead and fit new aids to the
claimant and then simply inform ACC of what has changed in terms of
the aid’s serial number and even, perhaps, battery size?
Yes, the audiologist can fit new aids. Unless the client is eligible for new
hearing aids under regulations, all costs will need to be covered by insurance
and/or the client. ACC requests that the audiologist provide ACC with a copy
of the manufacturer’s invoice for the new aids, as this will give us the serial
numbers and manufacturer’s warranty information, as well as any details for
change of batteries.
49. Will the new regulations apply to clients whose hearing loss
claims are managed by other insurance providers (e.g. CRM and
AON)?
Yes, accredited employers and third-party administrators such as CRM and
AON are required to abide by the same legislation and regulations as ACC.
This means that they must pay as a minimum the ACC regulation entitlements
for entitled clients.
56. Can the Failed Fitting fee (HL11) be invoiced for each unsuccessful
hearing aid client trial?
The failed fitting fee, whether for a binaural or monaural failed fitting, is
payable only once every six years.
64. If a client has lost their hearing aids and they have no contents
insurance does ACC replace the aids as per the old scheme?
If a client has not had a hearing aid contribution under regulations from ACC
for six years the client may apply to ACC for a contribution to their
replacement hearing aids.
87. Are claimants still able to claim for travel expenses?
Yes. The regulations do not introduce any changes regarding travel expenses.
91. We have had people coming in who have evacuated from
Christchurch due to the earthquake and who were unable to get their
batteries prior to leaving their homes. Is ACC able to accept any
batteries being invoiced by clinics to tide these people over. The
batteries are normally very slow being dispatched from the distributor
and as at this stage the people do not know how long they will be out
of Christchurch, they need assistance now. We have been giving
packets away - but as this will go on for a while yet - have you put
anything into place?
We have discussed this situation with our supplier (Propharma) and amended
the battery order process for those clients impacted by the earthquake. If a
client asks an audiologist for batteries the audiologist should contact ACC and
advise the client's name, battery type, numbers of packs and the client's
temporary delivery address. ACC will immediately process the order and
Propharma will endeavour to despatch the batteries the same day. This
should result in delivery to the client within a maximum of two working days.